Double switch operation in cardiac anomalies with atrioventricular and ventriculoarterial discordance

J Thorac Cardiovasc Surg. 1994 Feb;107(2):351-8.


Since June 1987, 10 of 19 consecutive patients with atrioventricular and ventriculoarterial discordance (average age 4 +/- 2 years) had undergone a double switch operation with the morphologically left ventricle used as a systemic ventricle. There were two combinations of procedures. Atrial switch combined with arterial switch was used in two patients who had a normal pulmonary valve. Atrial switch combined with ventriculoarterial switch by Rastelli's procedure was used in eight patients with pulmonary stenosis or atresia and a large ventricular septal defect. One early death and two late deaths have occurred in a postoperative follow-up period of up to 4 years. Subsequent problems were mainly related to the results of atrial switch procedures in patients who had a small atrium because of low pulmonary flow, especially in patients with apicocaval juxtaposition. Our experience suggested that the double switch operation would open a new era of definitive surgical treatment in half of the patients with atrioventricular and ventriculoarterial discordance.

MeSH terms

  • Aorta / surgery*
  • Cardiac Surgical Procedures / methods
  • Child
  • Child, Preschool
  • Female
  • Heart Atria / abnormalities*
  • Heart Atria / surgery
  • Heart Defects, Congenital / surgery*
  • Heart Ventricles / abnormalities*
  • Heart Ventricles / surgery
  • Humans
  • Male
  • Pulmonary Artery / surgery*
  • Treatment Outcome